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Postgraduate Education Corner |

A 92-Year-Old Woman With Recurrent Pleural Effusions*

Saed Nemr, MD; Maria H. Mayor-Modesto, MD; Stanley Schwartz, MD; Eleanor M. Summerhill, MD, FCCP
Author and Funding Information

*From Memorial Hospital of Rhode Island, Warren Alpert School of Medicine at Brown University, Pawtucket, RI.

Correspondence to: Eleanor M. Summerhill, MD, FCCP, Memorial Hospital of Rhode Island, 111 Brewster St, Pawtucket, RI 02860; e-mail: Eleanor_Summerhill_MD@Brown.edu


Chest. 2008;134(1):196-199. doi:10.1378/chest.07-2529
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A 92-year-old woman of Portuguese origin with hypertension, diabetes, and end-stage renal disease presented with atraumatic left-sided back pain. She denied fever, chills, cough, dyspnea, or lower-extremity edema. Evaluation revealed a large left-sided pleural effusion (Fig 1 ). Pleural fluid was grossly bloody, with pH 7.12; RBCs, 99,200/μL; WBC count, 7,200/μL (mononuclear cells, 63%; polymorphonucleocytes, 26%; lymphocytes, 8%; and eosinophils, 3%); protein, 4.3 g/dL; lactate dehydrogenase, 11,614 IU/L (serum lactate dehydrogenase, 243 IU/L); and glucose < 10 mg/dL. After an indwelling thoracostomy tube was placed, the patient was discharged without a definitive diagnosis. Two weeks later, she returned noting progressive dyspnea.

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